Conversations With a 23-Year Old About Health Reform

November 22, 2013

So, healthcare reform is in our face, hitting our checkbooks, and so very confusing. However, never was the challenge as clear to me as today, after spending some time speaking with a young man and his mother while sharing a natural hot spring in Genoa, NV, where I was taking a little R&R.

This is how the discussion went:

Me: So, what are you interested in?
Him: Being a firefighter and paramedic.
Me: While you are in school, do you have health insurance through your college?
Him: I don’t know.
Mom: He may get it through his father… I think.
Me: At 23, he still has three more years to be covered by your insurance.
Mom: Hmm. I did not know that.
Him: I didn’t either. I am pretty healthy.
Mom: Well, last year he took a terrible fall skiing.
Him: Yup. Tore some muscles in my back, but no bones.
Me: So, aren’t you glad that you can be covered by your folks’ insurance?
Him: I don’t really care. I am young.
Me: Well, as a firefighter, you will have to carry a 100 pound pack on your back, which could be a problem given your back injury. And, don’t you think that your future job will be effected by healthcare reform?
Him: I never thought about it.

Wow. He has never thought about it. Doesn’t seem or have to care.

Who today — especially young people whose future is going to be longer than their past — has the luxury of not caring about health reform? There is no going back. And, for this young man, he will eventually find out about healthcare — but who knows when or under what circumstances.

Lest it may seem that he is an exception, he is not. For example, according to a recent poll, 71% of uninsured Americans are still not familiar with Obamacare.

The Affordable Care Act has many layers.  Once we get past this initial website hassle, the real issues are staying healthy, spreading the cost meaningfully over all of us so that all of us can get healthcare.  And, for the first time, insurance companies are accountable to all of us and have to put the majority of their collected monies into patient care.

The part each of us really plays is not just being insured; rather it is about being aware, caring, and doing our best to stay healthy.  We need to take advantage of all the preventative services that are now covered.

At the same time, for those of us working in healthcare, what matters at the bedside is not the economic design of the healthcare system, nor the segregation of the insured from uninsured, or the political beliefs of individuals.  What matters is the role of all those who come in contact with patients to relieve suffering and facilitate recovery.

No matter what happens around us, caring for the welfare of an individual who is acutely ill transcends the healthcare rhetoric and replaces it with compassion and empathy.